Suture clip

ABSTRACT

Eliminates the need for tying knots in sutures. The clip (20) is slidable in an open position along sutures (12) that extend from a suturing site. With the clip (20) at the suturing site, the sutures (12) are tensed and the clip is forced into a closed position that fixes the position of the clip (20) relative to the sutures (12).

TECHNICAL FIELD

This invention relates to clips used in surgical procedures andparticularly to clips for securing the free ends of sutures.

BACKGROUND INFORMATION

Sutures are commonly used to close incisions and to reunite damagedtissue. Typically, the sutures are passed through the tissue and thefree ends of the sutures are tied together. In many instances, thesuturing site is exposed to an extent that is sufficient to permit thesurgeon to quickly tie the suture by hand. However, in some procedures,such as arthroscopic surgery, the suturing site is inaccessible by hand.As a result, the surgeon must tie the suture ends into a knot at alocation remote from the suture site, and then manipulate suitablyconfigured instruments for sliding the knot to the site.

For example, an arthroscopic surgical procedure usually employs asmall-diameter cannula that extends through a small incision made in ajoint. The sutures extend from the suturing site through the cannula.The exposed free ends of the sutures are tied by the surgeon and theknot is slid through the cannula to the suturing site. Such a suturingprocedure is time consuming and can result in knots that do not hold thesuture ends with sufficient tension to securely reunite the tissue.

SUMMARY OF THE INVENTION

This invention relates to a suture clip that eliminates the need fortying knots in suture ends. The clip is slidable along a suture or pairof sutures from a remote location to a suturing site. With the clip atthe suturing site, the suture is tensed and the clip is closed againstthe suture to securely fasten the suture at the site.

The suture clip of the present invention comprises a pair of legsattached together at one end by a hinge. The clip is made of resilientmaterial, such as plastic. The clip is configured so that the elasticityof the plastic biases the legs toward a generally V-shaped orientationthat defines the open position of the clip. Prongs are attached to oneleg for holding both legs together in a closed position.

The prongs and clip legs define a passageway whenever the clip is in anopen position. The free ends of a suture are threaded through thepassageway. With the sutures threaded through the passageway, the opensuture clip may be slid along the sutures without passing laterally awayfrom the sutures because the passageway surrounds the sutures. The clipis slid down the sutures and passed through the arthroscopic incisionuntil it reaches a position adjacent to the tissue where the suture isto be secured. An appropriate surgical instrument is used for slidingthe clip along the sutures and for closing the clip. When the clip isforced into the closed position, the legs pinch the sutures to fastenthe clip and sutures together.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of one embodiment of a suture clip of thepresent invention, showing the clip in an open position.

FIG. 2 is a cross-sectional side view, taken along line 2--2 of FIG. 1,showing sutures passing through the open clip.

FIG. 3 is a side view of the clip of FIG. 1, showing the clip in aclosed position with sutures pinched between the legs of the clip.

FIG. 4 is a perspective view of another embodiment of the presentinvention, showing the clip in an open position.

FIG. 5 is a side view of the suture clip of FIG. 4.

FIG. 6 is a side view of the suture clip of FIG. 4, showing the clip ina closed position with sutures pinched between the legs of the clip.

FIG. 7 is a perspective view of another embodiment of the presentinvention, showing the clip in an open position.

FIG. 8 is a side view of the embodiment of FIG. 7.

FIG. 9 is a cross-sectional view, taken along line 9--9 of FIG. 8.

FIG. 10 is a side view of the embodiment of FIG. 7, showing the clip ina closed position with sutures pinched between the legs of the clip.

FIG. 11 is a cross-sectional view, taken along line 11--11 of FIG. 10.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

FIGS. 1, 2 and 3 show one embodiment of a suture clip 20 formed inaccordance with the present invention. The suture clip 20 includes anupper leg 21 and a lower leg 22, joined at a flexible hinge 23. The legs21, 22 move about the hinge 23 between an open position (FIG. 1) and aclosed position (FIG. 3). The clip 20 is formed of resilient materialthat normally biases the clip toward the open position, wherein the legs21, 22 assume a V-shaped orientation.

A first prong 24 and a second prong 25 are attached to the lower leg 22and extend toward the upper leg 21. The prongs 24, 25 are attachedbetween the hinge 23 and the free end 26 of the lower leg 22.

The upper leg 21 has an opening 27 that is located to receive the prongs24 and 25 whenever the clip 20 is moved to the closed position, asdescribed more fully below. Whenever the clip is in the open position,the prongs 24, 25 extend partly into the opening 27 (FIG. 2). Apassageway 28 is defined between the first prong 24 and second prong 25,and between the lower leg 22 and the upper leg 21. The passageway 28 hasno lateral opening. Consequently, one or more sutures 12 may be threadedthrough the passageway 28, and the open clip 20 may be slid along thelength of the sutures 12 without moving laterally away from the sutures.

For example, an open clip 20 may be slid along the sutures that extendfrom a suturing site that is located inside a joint that is accessibleonly by surgical instruments. As used herein, the term suturing sitemeans the location adjacent to the tissue to which the suture isconnected. The free ends of the sutures 12 that are exposed outside ofthe joint are threaded through the passageway 28 of the clip, and theclip is slid down the sutures 12. The clip 20 will remain in contactwith the sutures as it is slid to the suturing site because, as notedearlier, the passageway 28 in the open clip 20 has no lateral opening.In this regard, the sutures act as a guide for moving the clip to thesuturing site. Once in position at the suturing site, the suture istensed and the clip is closed (FIG. 3) by an appropriate surgicalinstrument, such as a clamp.

The prongs 24, 25 serve to lock the clip 20 in a closed position. Tothis end, a hook 29 is formed on the end of the first prong 24 and acorrespondingly shaped hook 30 is formed on the second prong 25. Thehooks 29 and 30 extend apart a distance that is greater than the lengthof the opening 27 in the upper leg 21. Consequently, as the upper leg 21is forced toward the lower leg 22, the first prong 24 and second prong25 are deflected toward one another as the opening 27 is slid over thecurved tops of the hooks. Once the hooks 29 and 30 extend through theopening 27, the prongs 24 and 25 snap apart so that the hooks 29 and 30extend partly over the outer surface 31 of leg 21 near the opening 27,thereby locking the clip 20 in the closed position. With the clip lockedin the closed position, the sutures 12 are firmly pinched between thelegs 21, 22 (FIG. 3) so that the clip is unable to slide along thesutures 12.

As best shown in FIG. 2, a curved platform 32 is formed between theprongs 24, 25. The platform 32 provides a surface that is raisedslightly above the inner surface 33 of the lower leg 22. The platform 32effectively carries the sutures 12 above the inner surface 33 of thelower leg 21 to ensure the sutures 12 will be tightly pinched betweenthe legs 21, 22 when the clip is closed.

The clip 20 is of unitary construction and is preferably made ofplastic. The plastic material provides the resiliency for urging theclip 20 into the open position and for permitting deflection of theprongs 24, 25 as described above. Preferably, the clip 20 is made ofmaterial that is gradually absorbed. Such materials are polyglycolicacid, polyactic acid and trimethylene carbonate copolymers.Alternatively, the clip may be formed of permanent or non-absorbablematerials, such a acetal homopolymers or copolymers, polyethylene,polyproplylene, and copolymers thereof.

FIGS. 4, 5, and 6 show another embodiment of the invention wherein thepassageway 128 of the clip 120 is defined by a single prong 124 attachedto the end of the lower leg 122. The hinge 123 biases the clip 120 intoa V-shaped open position (FIG. 5).

In the embodiment of FIG. 4, the single prong 124 is attached to thedistal end of lower leg 122 and extends toward the upper leg 12-. Whenthe clip is in the open position, the prong 124 is in contact with thefree end 126 of upper leg 121, thereby forming a passageway 128surrounded by the prong 124, the lower leg 122, and the upper leg 121.The passageway 128 has no lateral opening. Any sutures 12 that arethreaded through the passageway 128 are, therefore, substantiallysurrounded. As a result, the open clip 120 may be slid along the sutures12 without moving laterally away from the sutures.

The prong 124 serves to lock the clip 120 in a closed position. A hook131 is formed on the end of the prong 124. As the upper leg 121 isforced toward the lower leg 122, the prong 124 is deflected away fromthe upper leg 121 as the free end 126 of the upper leg 121 slides overthe angled top of the hook. Once the hook 131 extends over the uppersurface 133 of upper leg 121, the prong snaps back so that the hook 124extends partly over the upper surface 133 of leg 121 near the free end126, thereby locking the clip 120 in the closed position. When the clipis locked in the closed position, the sutures 12 are firmly pinchedbetween the legs 121, 122.

FIGS. 7-11 show another embodiment of the suture clip 220 of the presentinvention. This embodiment includes an upper leg 221 and a lower leg222, connected together at a flexible hinge 223. As with the otherembodiments, this clip is formed of a resilient material that biases theclip toward the open position, wherein the legs 221, 222 assume aV-shaped orientation.

A first prong 224 and a second prong 225 are attached to the lower leg222 and extend toward the upper leg 221. The prongs 224, 225 areattached between the hinge 223 and the free end 226 of lower leg 222.Each prong 224, 255 includes an inwardly protruding hook 230, 231.

The upper leg 221 has a first notch 227 located to receive the prong224, and a second notch 228 located to receive prong 225 when the clipis forced into the closed and locked position (FIG. 10). When the clip220 is in the open position (FIG. 8), the hook 230 on prong 224 contactsthe leg 221 at one notch 227, and the hook 231 on prong 225 contacts theleg 221 at the other notch 228.

A passageway 229 is defined between the first prong 224 and the secondprong 225, and between the lower leg 222 and the upper leg 221. One side232 of the first prong 224 and the corresponding side 233 of the secondprong 225 are curved such that the passageway 229 is essentiallycircular (FIG. 8) when the clip is in the open position. The passageway229 has no lateral opening and, as with the other embodiments, the openclip 220 may be slid along the sutures 12 without laterally moving awayfrom them.

With the sutures 12 threaded through the passageway 229, and the clip220 adjacent to the suturing site, the clip 220 is locked in the closedposition. In this regard, the hooks 230, 231 formed on the end of thefirst and second prongs 224, 225 have inclined facing surfaces thatpermit the upper leg 221 to be forced between the prongs 224, 225 as theclip 220 is moved into the closed position. As the upper leg 221 isforced toward the lower leg 222, the first prong 224 and second prong225 are deflected away from one another as the portions of the upper leg221 within the notches 227 and 228 push against the inclined surfaces ofthe hooks 230, 231. Once the hooks 230, 231 extend past the notches 227and 228, the prongs 224 and 225 snap together so that the hooks 230, 231extend partly over the top surface 234 of upper leg 221, thereby lockingthe clip 220 in the closed position. With the clip locked in the closedposition, the sutures 12 are firmly pinched between the legs 221, 222(FIG. 10) so that the clip is unable to slide along the sutures 12.

While the present invention has been described in accordance withseveral embodiments, it is recognized that variations and changes may bemade therein without departing from the scope of the invention as setforth in the claims.

I claim:
 1. A suture clip comprising:a first leg; a second leg attachedto the first leg, the first and second leg being movable relative to oneanother; and the clip being constructed of resilient material thatnormally urges the first and second legs toward a first position thatdefines a passageway that completely surrounds a suture that may bethreaded through the passageway, the first and second legs being movableto a second position for reducing the size of the passageway to preventmovement relative to the clip of a suture that is threaded through thepassageway.
 2. The suture clip according to claim 1, wherein the clip isformed of one piece.
 3. The suture clip according to claim 1, whereinthe clip includes a prong attached to one leg to define part of thepassageway when the legs are in the first position.
 4. The suture clipaccording to claim 3, wherein theprong is made of resilient material andattached to the first leg and has a hook on one end for engaging thesecond leg.
 5. The suture clip according to claim 4, wherein the hook isconfigured to engage the second leg to lock the first and second legs inthe second position.
 6. A suture clip comprising:a first leg; a secondleg attached to the first leg, the first and second leg being movablerelative to one another; positioning means for positioning the first andsecond legs at a first position to define a passageway that isconfigured for substantially surrounding a suture that may be threadedthrough the passageway, and for positioning the first and second legs ata second position for securing the suture relative to the clip; thepositioning means including a first prong made of resilient material andattached to the first leg and having a hook on one end for engaging thesecond leg, and a second prong having a hook on one end, the secondprong attached to the first leg to define part of the passageway whenthe legs are in the first position.
 7. A one-piece suture clip made froma resilient material and comprising:a first and second leg attached by ahinge and movable relative to each other between a first position and asecond position; two prongs attached to the first leg, the prongs andlegs defining a passageway that is configured for substantiallysurrounding a suture that may be threaded through the passageway, theprongs being configured for securing the legs in the second position forholding the threaded suture immovable within the passageway.
 8. Thesuture clip according to claim 7 wherein the prongs are configured tohook the second leg to lock the first and second legs in the firstposition.